The results of treatment of serous retinal detachment in the optic nerve fossa. Clinical case

2021 ◽  
pp. 188-190
Author(s):  
A.Y. Khudyakov ◽  
◽  
O.V. Kolenko ◽  
◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Retinal Detachment ◽  
Clinical Case ◽  
Serous Retinal Detachment ◽  
Internal Limiting Membrane ◽  
Temporal Part ◽  
Rare Occurrence ◽  
Results Of Treatment

Purpose. Demonstration of our own case of treatment of serous retinal detachment with a fossa of the optic nerve disc (OND). Material and methods. We observed patient B. at the age of 24 years with a diagnosis of optic nerve disc anomaly, central serous retinal detachment. Visual acuity on admission: 0.1, does not correct. A 25G endovitreal intervention was performed. With the help of tweezers, a flap of the internal limiting membrane (ILM) with a wide base was formed from the temporal part of the macula, within the vascular arcades. Then, liquid-air replacement was carried out, followed by placing the inverted flap of the ILM in the area of the OND fossa. Result. On the 5th day after the operation, visual acuity improved to 0.2, metamorphopsias decreased. According to the data of optical coherence tomography (OCT), a significant decrease in the height of neuroepithelial detachment was noted. After 4 months visual acuity reached 0.4. Complaints about metamorphopsia were stopped. The OCT picture showed a complete absence of retinal detachment. In this case, the inverted flap of the ILM in the area of the OND fossa was clearly visualized. Conclusion. 1. The displaced inverted flap of the ILM can be used to close the defect in the OND fossa. 2. This method made it possible to stop serous retinal detachment and significantly improve visual functions. 3. Given the rather rare occurrence of this pathology, further replication of this method is necessary to test its effectiveness. Key words: serous retinal detachment, fossa of the optic nerve disc, inverted flap of the internal limiting membrane.

Hypertensive choroidopathy in atypical hemolytic-uremic syndrome

2019 ◽  
pp. 112067211989628
Author(s):  
Maria Sole Polito ◽  
Federica Machetta ◽  
Antonio M Fea ◽  
Chiara M Eandi
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinal Detachment ◽  
Hemolytic Uremic Syndrome ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Serous Retinal Detachment ◽  
Systemic Hypertension ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Uremic Syndrome

Purpose: We present the case of a 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome with a hypertensive crisis, who presented a bilateral serous retinal detachment. Case Description: A 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome, was referred for blurred vision in both eyes, evolving over 7 days. Treatment including hemodialysis, plasma exchange, systemic steroids, antihypertensive medications and eculizumab was started 1 month prior to referral. At presentation, best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye. Retinal examination revealed bilateral serous retinal detachment in the posterior pole and some small, flat, variably pigmented lesions. Optical coherence tomography confirmed marked serous retinal detachment in both eyes. Fluorescein and indocyanine green angiography was performed. Treatment for systemic hypertension was changed. Seven days later, dilated fundus examination and optical coherence tomography demonstrated a significant regression of the serous retinal detachment. Her visual acuity improves in both eyes at the last control, showing at fundus examination a complete resolution of the exudative detachment but a persistence of variable flat pigmented lesion. Conclusion: Although multiple organ systems are commonly affected in hemolytic uremic syndrome, ocular involvement has only been described in very few cases. Ocular manifestations in atypical hemolytic uremic syndrome include retinal, choroidal and vitreal hemorrhages, retina and/or ischemic signs. Bilateral serous retinal detachment may also be a sign of atypical hemolytic uremic syndrome or even the first manifestation of a hypertensive event.

Results surgical treatment of rhegmatogenous retinal detachment and macular hole

2021 ◽  
pp. 97-99
Author(s):  
A.V. Zhigulin ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Macular Hole ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Optical Coherence ◽  
Primary Surgery ◽  
Analysis Of Results

Purpose. Analysis of functional and anatomical results surgical treatment of retinal detachment and macular hole (RDMH) with internal limiting membrane (ILM) peeling and silicone tamponade. Material and methods. Analysis of results surgical treatment of 17 patients (17 eyes) with RDMH was carried out. Disease duration ranged from 2 weeks to 3 months. Visual acuity before surgical treatment ranged from no light perception to 0.05 (on average 0.01±0.02). All patients underwent endovitreal surgery with ILM removal. Then retinal holes were localized at periphery with further endolaser coagulation or cryocoagulation and silicone oil (5700 cSt) tamponade. Results. Retinal adhesion was noted in all eyes after primary surgery. Closure of hole was successful in 16 patients. After operation, visual acuity improved in all patients, averaging 0.11±0.09. Conclusion. Vitrectomy with IPM removal and silicone oil (5700 cSt) tamponade in treatment of RDMH made it possible to achieve reattachment of retina in 17 patients, complete closure of macular hole in 16 of 17 patients. One patient, according to optical coherence tomography, showed decrease diameter of macular hole after 12 months. Positive functional effect was achieved in increase visual acuity to average of 0.15±0.15 after 12 months. Key words: retinal detachment, macular hole, vitrectomy, internal limiting membrane removal, silicone oil tamponade, visometry, optical coherence tomography.

Internal limiting membrane graft as a treatment for the retinal detachment secondary to an optic disc coloboma

2021 ◽  
pp. 112067212199268
Author(s):  
Jorge Fernández-Engroba ◽  
Muhsen Saman ◽  
Jeroni Nadal
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Optic Disc ◽  
Subretinal Fluid ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Subretinal Space ◽  
Direct Closure ◽  
Retinal Tears ◽  
Optic Disc Coloboma

Purpose: To report our anatomical outcome with the internal limiting membrane (ILM) graft procedure in the management of rhegmatogenous retinal detachment (RRD) secondary to optic disc coloboma (ODC). Methods: Description of a new surgical procedure in one eye of one patient who underwent pars plana vitrectomy (PPV) combined with ILM graft technique. Subsequent follow-up included optical coherence tomography (OCT) and visual acuity. Results: After only 1 week, the OCT revealed the ILM graft plugging the retinal tear with complete resorption of subretinal fluid. The sealing effect of this graft persisted after 6 months. However, visual outcome was poor and corrected distance visual acuity was 20/200 as a result of the previous long-standing retinal detachment with loss of photoreceptors. Conclusion: We suggest that ILM graft could be performed as a first line treatment in the management of RRD secondary to ODC. This direct closure of the retinal tears, allows a quick and effective interruption of the communication between the subretinal space and the vitreous cavity. Detecting these retinal tears and applying this technique as soon as possible could achieve not only an earlier anatomical success but obtain good visual results in retinal tears with RRD secondary to ODC. Further studies will be necessary to provide more evidences

Possibilities of modern visualisation of helminthic chorioretinitis

Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 12-17
Author(s):  
E.V. Arkhipov ◽  
◽  
S.I. Zhukova ◽  
N.V. Zaitseva ◽  
◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Clinical Case ◽  
Clinical Laboratory ◽  
Three Dimensional ◽  
Comprehensive Analysis ◽  
Oct Angiography ◽  
Standard Analysis ◽  
Complex Reconstruction ◽  
Paracentral Scotoma

Purpose. To present a rare clinical case of helminthic chorioretinitis in a child and to demonstrate the informative value of a comprehensive analysis of optical coherence tomography (OCT) in identifying the etiological nature of the disease. Methods. The results of clinical, laboratory and instrumental examination of a patient with chorioretinitis caused by ascaris. Results. After etiotropic therapy, the patient had an increase of visual acuity from 0.8 to 1.0 and a two-fold decrease of paracentral scotoma. Conclusion. The presented case shows high informative value of combination of standard analysis of retinal maps and sagittal scans with the complex reconstruction of three-dimensional image and analysis of frontal scans obtained in OCT-angiography (OCTA) mode. Key words: chorioretinitis; helminthiasis; OCT-angiography.

scholarly journals Internal Limiting Membrane Flap in the Management of Retinal Detachment due to Paracentral Retinal Breaks

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yen-Chih Chen ◽  
Chung-May Yang ◽  
San-Ni Chen
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Structural Changes ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Major Complication ◽  
Internal Limiting Membrane ◽  
Fluid Exchange ◽  
Membrane Peeling ◽  
Retinal Breaks

Purpose. To describe the technique and outcomes of using either inverted or free internal limiting membrane flap in the management of retinal detachment due to paracentral retinal breaks. Methods. This retrospective observational case series includes nine patients who received surgery for retinal detachment due to paracentral retinal breaks developed either from primary rhegmatogenous origin, or secondary iatrogenic retinal breaks after prior membrane peeling, or during surgery for tractional retinal detachment. Either inverted or free internal limiting membrane flaps were inserted in the identified breaks, followed by air fluid exchange and gas tamponade. Visual acuity and structural changes were evaluated. Results. Nine eyes were included. One had primary rhegmatogenous retinal detachment, one had highly myopic eye with peripapillary atrophic hole, three had secondary retinal detachment after membrane peeling for foveoschisis or macular pucker, one had recurrent retinal detachment due to proliferative vitreoretinopathy, one had combination of tractional and rhegmatogenous retinal detachment, and two had iatrogenic breaks during surgery. The retinal breaks of all eyes were sealed with retina attached postoperatively. Visual acuity in logarithm of minimal angle of resolution improved from 1.18 ± 0.55 preoperatively to 0.74 ± 0.47 postoperatively (p=0.04). Conclusion. Internal limiting membrane flap technique can be a surgical approach selectively for retinal detachment due to paracentral retinal breaks with difficulty for laser application. The retina can be attached successfully and achieve good visual outcome without major complication. This trial is registered with NCT03707015.

scholarly journals The Use of Inner Retinectomy to Relieve Inner Retinal Foreshortening Causing Retinal Detachment in the Setting of Branch Retinal Vein Occlusion

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Katsuya Yagisawa ◽  
Takayuki Baba ◽  
Tomomi Kaiho ◽  
Hirotaka Yokouchi ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Japanese Woman ◽  
Vein Occlusion ◽  
Initial Surgery ◽  
Old Japanese

A 61-year-old Japanese woman presented with impairment of her left vision due to macular schisis secondary to branch retinal vein occlusion. Her left vision was 20/50, and schisis was observed inferotemporally. She underwent phacoemulsification and aspiration, implantation of the intraocular lens, and removal of the epiretinal membrane and internal limiting membrane. Her visual acuity stabilized ~20/50 for two and a half years after the initial surgery. However, she developed macula-involving retinal detachment, and her visual acuity declined to counting fingers. She underwent pars plana vitrectomy and removal of the residual vitreous cortex together with the inner retina within the area of vein occlusion. After the removal of silicone oil and the addition of an encircling buckle, the retina remained attached and visual acuity improved to 20/60 at one year after the final surgery. The combination of rhegmatogenous and tractional detachment in the area of schisis was suspected, and vitrectomy with inner retinectomy was effective.

scholarly journals Optical coherence tomography findings predictive of response to treatment in diabetic macular edema

2018 ◽  
Vol 46 (11) ◽  
pp. 4455-4464 ◽  
Author(s):  
Young Joo Cho ◽  
Dong Hyun Lee ◽  
Min Kim
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Serous Retinal Detachment ◽  
Intravitreal Bevacizumab ◽  
Internal Limiting Membrane ◽  
Response To Treatment ◽  
Optical Coherence ◽  
Sd Oct

Objective To evaluate the short-term efficacy of intravitreal bevacizumab (IVB) and posterior sub-tenon triamcinolone injections (PSTI) on the basis of spectral-domain optical coherence tomography (SD-OCT) patterns in diabetic macular edema (DME). Methods We retrospectively reviewed 73 eyes of 73 patients with DME. Based on the presence of serous retinal detachment (SRD), eyes were categorized into two groups, and either IVB or PSTI treatment was performed. Central macular thickness (CMT) and the degree of SRD were assessed preoperatively and 1 month postoperatively. The severity of intraretinal edema was approximated based on the distance from the external limiting membrane to the internal limiting membrane. Results In eyes with SRD, reduction of SRD was greater with IVB than with PSTI. Moreover, reduction of intraretinal edema was greater with PSTI than with IVB. In eyes without SRD, PSTI achieved greater CMT reduction, compared with IVB. Conclusions In DME patients with SRD, IVB achieved greater reduction of SRD, compared with PSTI; however, intraretinal edema responded more favorably to PSTI, regardless of the presence of SRD. Our results suggest that the classification of DME based on OCT findings may be useful to predict responses to IVB or PSTI treatments.

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